Marco Osti Avila is an anaesthetist and worked in Nigeria.
In one moment I was learning about Médecins Sans Frontières in my Welcome Days (the pre-departure training course) and in the other I was flying to Port Harcourt, Nigeria, for my first placement with Médecins Sans Frontières. Teme Hospital is a 70-bed trauma centre hospital and is the only hospital providing free of charge medical care to Port Harcourt’s population. In the hospital, we were confronted with the results of violence every day. Médecins Sans Frontières has been running this hospital since October 2005 and during this period there have been sporadic outbreaks of violence. However, the most common cause of injury that I saw while working there for seven weeks was due to the chaotic traffic in the city.
Médecins Sans Frontières has an average of 250 surgical cases monthly and about 70% of them were related to traffic accidents. There were also gunshot wounds, stabbings, serious beatings and cases of sexual violence to be treated. Every single day we received new cases in the emergency room of Teme Hospital. Independently of the cause of the injury, 80% of all surgical cases between 4 June 2009 and 17 July 2009 were orthopaedic.
As an anaesthetist in this project, I was responsible for running the operating theatres, management of pain, thromboprophylaxis (prevention of thrombosis i.e. the forming of blood clots), infection control and helping in the emergency department. I found the equipment in very good condition and I was able to work comfortably during my time there. The national staff were also a pleasure to work with. I had the opportunity of providing training for them and they were strongly interested in learning and totally committed to the Médecins Sans Frontières protocols. All surgical teams worked every weekday and weekend (and some evenings) without a single day off. It was a short placement. Seven weeks in the field is not too much but working in an emergency and surgical project is something intense no matter how long you are going to stay there for.